Morris Panner, Ambra Health Chief Executive Officer

Today, somewhere in America, a patient will receive a copy of their medical imaging on a CD. It’s hard to believe that this relic of the 90s still exists, let alone is in regular use at healthcare facilities. Many home computers and laptops no longer contain disc drives necessary for loading CDs, making the process for patients to view imaging inconvenient and cumbersome. And patients aren’t the only ones negatively impacted by the continued use of CDs.

The cost healthcare organizations incur from purchasing, burning, and couriering CDs is enormous. Hospitals can still spend as much as $15 per CD, according to 

 and some health systems spend upwards of $100,000 per year in courier costs alone.

The financial costs are only one part of the problem. If I challenged you to rummage through your old desk drawers, I bet you could find several, if not dozens, of old CDs destined for the landfill. This issue is exponential for radiology departments. It takes a CD roughly 

The 21st Century Cures Act and consumer demand has added momentum to the movement away from CDs and towards cloud-based imaging systems. This Earth Day, let’s commit to ditching the disc entirely. It’s better for patients, providers, and the planet.

Moving to Cloud-based Imaging is a Win-Win

In addition to reducing items destined to the landfill, moving to a cloud-based imaging system provides patients better access to imaging, saves facilities money, and improves care.

Adopting new technologies like these can go a long way toward meeting the growing 

 for access to personal health records. Cloud-based platforms enable medical facilities to create 

 that provide instant access to information and images.

The benefits of moving to a cloud-based imaging system for facilities are well documented – a reduction in administration time and lower burnout rates among staff, fewer processing errors, and less unnecessary redundant imaging exams to name a few.

For example, at Gunnison Valley in Colorado, the mountains bring in both a winter ski population and a summer hiking population, as well. However, with many tourists heading home at the end of each season, sending imaging via CD for follow-ups with home physicians quickly became a burdensome and expensive task. Particularly, during the winter, mailing a CD could take weeks if a snowstorm hit the region. Embracing the #DitchTheDisk movement, the marketing team was able to quickly spread the word regarding simplified electronic image-sharing. Today, imaging can be shared with patients and referring physicians in just a few seconds.

 that healthcare facilities spend more than 84 days per year on CD upload, burning, and patient data matching alone. Try 

 to determine just how much money your facility may be spending on CDs.

Every month, approximately 100,000 pounds of CDs become obsolete, 

 to the Environmental Protection Agency. Most are destined for the landfill or incinerator. One of the easiest ways to keep CDs out of the landfill is to reuse them, but due to sensitive personal health information, that’s not always an option for radiology departments.

Depending on their condition, CDs can be recycled for use in new products. Specialized recycling companies clean and grind the disc into raw polycarbonate plastic, resulting in white and clear powdery material that resembles snowflakes. The raw polycarbonate plastics can, then, be sold and melted down for a variety of new purposes, including in automotive parts, office equipment, and municipal electrical cable insulation. And 

The market for recycled CDs still remains nascent, according to the 

, which recently did an in-depth look on the life cycles of CDs. And when choosing to recycle, one must consider the carbon footprint tradeoffs for transporting the CD to a designated recycling center.

Prior to modifying your waste disposal practices, you’ll want to ensure any new actions meet HIPAA 

 of disposing media containing personal health information. Here are several options for recycling unused or clear CDs and other “techno-trash.”

 (founded on Earth Day in 1993 and headquartered in Sammamish, Wash.) is a fee-based service that offers a variety of options from “starter kit” to enterprise options for transporting “techno-trash” to their recycling processing plant.

 is another option. Operations are currently paused due to the pandemic, but you can request to be placed on a mailing list to be notified of its reopening.

Another option is to check with your local waste management company. Many municipal waste management companies have directions online on how and where to recycle or properly dispose of CDs and other “techno-trash.”

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Pivoting from CDs is a win for radiology, you just need to know how to do it.



Still Using CDs? Why You Should Ditch the Disk This Earth Day 

Whether you love or hate social media, there’s no denying its ubiquity. Over the past few years, radiologists have gone social and for good reason. We’ve seen social media’s utility play out even more during the pandemic -- providing valuable social connection and serving as a real-time communication tool for safety updates and information. Physicians today are using social media to find mentors, act as patient advocates, seek and share education, and build personal brands.

It should also be no surprise that physicians are taking an interest in social media as a younger generation settles comfortably into their careers. More than any generation before them, millennials search for recommendations regarding physicians and facilities online. An outdated website, lack of reviews, and difficulty accessing critical information could be a major turn-off.

But, it’s not just millennial radiologists using social media. Case in point? My favorite platform for engagement is Twitter, and I am certainly beyond the millennial generation. Radiology as a field has also recognized the importance of social media. With social platforms increasingly image-based, they are well suited to serve up bite-sized educational content for radiologists. On Instagram, “case of the day” challenges are becoming increasingly popular.

For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-newsletter

Social media, however, is not without its downfalls, and regardless of which platform you’re using, physicians should be aware of best practices and potential problem areas to ensure healthy online engagement. Here are a few best practices for those looking to start or build their social presence.


Follow the rules: First and foremost, review your facility’s social media and marketing policies to ensure compliance. If you feel as though it is time for a change and an increased social presence, engage with senior leadership for a discussion on the topic. Facilities frequently have guidelines in place to protect patient health information.

Find your audience: Determine which platform is best suited to your social goals. Looking for educational content? You might consider Instagram. Want to connect with others professionally? Set up your LinkedIn. Looking to engage in real time conversation? Twitter will be a good place to start. It’s important to think through what you're looking to achieve with social for your personal or practice’s brands.

Connect with others: Social media is afterall, social. Once you set up your account It’s important to grow your follower base. You can do this by posting engaging content, following others and participating in forums and group discussions. Search for relevant hashtags to add to your content to make sure you’re getting noticed in relevant conversations.

Never share patient information: This is especially important for organizations posting educational content. Never share patient personal health information. Be cautious that no PHI can be seen in any photos.

Determine your personal and professional line: The lines today between our personal and professional lives are even more blurred but make sure you have a plan for how you want these words to collide in your online social spheres. Consider maintaining both private personal and professional accounts to keep conversations pertinent and appropriate.

Keep your profiles fresh and up-to-date. Make sure you have an updated photo, descriptor, and that you’re engaging on a regular basis. Now would be a good time to audit your existing profiles to make sure they’re up-to-date if you haven’t done so recently.

Social media is a fantastic way to network, share your work, and learn from others. Follow the guidelines above to stay safe while posting away!

Stepping Out of the Darkroom and Into Social Media 

A picture is worth a thousand words, yet many hospitals and health systems still rely on outdated, siloed, and on-premise technology for storing and transferring medical imaging. This outdated technology leads to most electronic health records (EHRs) missing a patient’s diagnostic imaging and only displaying text-based radiology reports. Imagine Facebook or Instagram with just words and no images; it’s a far less comprehensive picture of the individual.

The COVID-19 pandemic has ushered in a new sense of urgency for facilities to break down traditional barriers and allow seamless access to medical imaging data for trauma transfers, everyday telehealth appointments, second opinions, and more. A patient should never face a care delay due to the delayed arrival of medical imaging.

Teamwork between providers and coordination among various points from imaging centers, primary care physicians, and hospital surgical units are absolutely critical. U.S. hospital mergers and acquisitions have been a high rate for the past several years, and today’s patients may find themselves moving through several different locations rather than completing every test at one large hospital. Many physicians feel “trapped” and exhausted by onsite hardware and siloed systems. The administrative time currently spent shuffling around CDs, rekeying information on studies, and maintaining virtual private networks to exchange imaging and associated data is immensely frustrating and cost prohibitive.

 has shown that the average facility burns about 1,911 CDs per month. With each CD upload taking a few minutes (in a best-case scenario), that could waste hours each day. Administrators and clinicians are frustrated by this enormous waste of time with over 74 percent believing that eliminating CDs could increase job satisfaction.

Image enabling an EHR system takes away the frustration of dealing with CDs and logging into two systems and toggling between them. Instead, both patient records and imaging are all available directly from within the patient jacket. Single sign-on integration seamlessly authenticates users into the EHR for image viewing, with no need for multiple logins. Since imaging and data are integrated together within the patient jacket, patient health information also remains in sync.

Another key benefit of image-enabling the EHR is that it provides enterprise-wide viewing of a study simultaneously. In other words, multiple specialists can access and view an exam at the same time and from different places. For example, at UC San Diego Health, staff can upload studies off CDs within minutes with Ambra Health, and the study becomes available for network-wide viewing immediately. The workflow allows UC San Diego Health to match data from Epic to the CD and overrides the information on the disk. Ambra’s integration with Epic’s affiliated physician portal enables physicians to view imaging directly from the order record. It can also be configured for the physician to be able to view any prior imaging studies for the patient based on a Medical Record Number (MRN).

The current shift towards telehealth services has forced hospitals and health systems to evaluate their processes for sharing patient data. With the increase of remote visits and desire from patients to have access to their records, remote sharing has become a crucial part of medical records management. Patient and referring physician portals enable hospitals and health systems to automatically and easily share studies and reports with patients and referring physicians, making life easier and more efficient for patient and referring physician populations.

Image-enabling the EHR opens the doors to an image-enabled patient portal. The patient experience starts the moment they walk into your office and are greeted by front desk staff. Wasting time searching for an old CD, struggling to upload the images, or letting a patient know that their images are inaccessible for any reason are a less than ideal way to start any visit. Streamline processes by offering patients the ability to upload prior imaging from CDs directly to you ahead of an appointment. 

Or better yet, stay connected through the cloud to local imaging centers that frequently send to your office so that patient imaging appears directly in your EHR system leading to a seamless appointment. After the appointment is over, providing patients with a user friendly and easy-to-access patient portal is a great way to stay in touch and encourage patients to take control of their own health data and, in turn, their health as a whole.

Image-enabling the EHR can have long-term health benefits for patients. The U.S. Food & Drug Administration’s Center for Devices and Radiological Health (CDRH

Unnecessary Radiation Exposure from Medical Imaging

. The CDRH developed several key initiatives that keep in mind that imaging exams must do more good than harm. Among these was a movement to incorporate key quality assurance practices into both hospitals and imaging facilities.

Image enabling the EHR allows physicians easy access to patient imaging – reducing the number of duplicate test orders and the amount of radiation exposure. In addition, a cloud-based suite allows physicians to not only place the current order, but also search archived imaging for all previous medical imaging associated with that patient across their network.

As busy physicians spend their days suiting up in personal protective gear and face a steady stream of patients, the last thing they should need to worry about is logging into multiple systems to access critical information. It’s time for facilities to push towards greater interoperability and unified systems.

It is time for facilities to push for greater interoperability and unified systems. 

Why Image-Enabling the EHR Benefits Patients and Providers Alike

A small silver lining of this global pandemic may be the realization that we do not always need to take a full day off work to head to the doctor’s office. The concept of telehealth has existed for several years now but was rarely a reality. In fact, I cannot recall a single physician of mine that offered telehealth as an alternative to appointments prior to the COVID-19 pandemic.

Today, many physicians are more than willing to conduct telehealth visits for minor aches and pains, routine check-ins, an initial screening, or even a second opinion. Not only has the increase in telehealth been beneficial for busy patients (who are often managing both work and children at home) but also for physicians who find themselves in far less crowded offices.

, more than 79 percent of specialists surveyed said that their use of telemedicine has increased since the pandemic began. Many also said that they would continue to use virtual services in the future. The increased use of telemedicine was made possible by several key legislation changes. The U.S. Health and Human Services Office for Civil Rights announced that it will, “not impose penalties for non-compliance with the regulatory requirements under the HIPAA Rules against covered healthcare providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency." Additionally, Centers for Medicare and Medicaid Services 

expanded its Medicare telehealth coverage during the COVID-19 pandemic

 for telehealth services during March and April of 2020. 

Remote Reading? 4 Experts Weigh in on the Post-Pandemic Future of Teleradiology

Telehealth has been a long time coming. Physicians have sought creative ways to reduce the number of patients entering and exiting facilities, including imaging centers, for years, testing a number of different methods. For example, r

 followed patients in 2017-2018 and studied whether an electronic consultation between radiologists and referring physicians could lower unnecessary imaging exams. Positive care improvements were seen with the use of this program. Unnecessary imaging went down and in more than 55 percent of cases, imaging that was still recommended altered patient care plans for the better. 

Radiology as a specialty has always been at the 

 with teleradiology work being commonplace for over a decade. Radiologists are often able to work securely from home and offer tele-consults with patients who may have additional questions regarding findings. At New York University Langone, about 25 percent of radiologists read from home. Today, that number has 

However, both patients and physicians should not dismiss the need for in-person care when appropriate. For example, since the outbreak of COVID-19, there has been a 

 leading to poorer prognosis for patients. 

The post-COVID world will need to establish a critical balance between appropriate telehealth usage and in-person visits, imaging exams, and procedures. Could artificial intelligence play a role in determining usage? Advanced symptom-based algorithms may be one such future tool that aid in differentiating between the necessity for telehealth or in-person care. In addition, wearable technology may be another tool that appropriately flags the need for increased intervention.

Our world is forever changed but what is clear is that telemedicine is here to stay, and facilities should build their strategies in anticipation. Organizations should examine their needs as a whole and avoid building a piecemeal approach to their telehealth strategy. Facilities scrambled to put into place whatever program was needed for initial needs. But, for telehealth to succeed in the long term, a truly robust and comprehensive strategy will be needed. If budgetary constraints are an issue for your facility, consider choosing a platform that could scale up at a later time.

Training for the entire team ranging from administrative support to physicians, and even patients, is also a necessity for long-term program success. A comprehensive approach is one that touches on each part of the healthcare trajectory and takes the patient on the best path possible for an ideal outcome.

Changes from COVID-19 have created a healthcare environment where telehealth – an in particular teleradiology – will be a permanent fixture.


Morris Panner, Ambra Health Chief Executive Officer

Articles

Still Using CDs? Why You Should Ditch the Disk This Earth Day

Stepping Out of the Darkroom and Into Social Media

Why Image-Enabling the EHR Benefits Patients and Providers Alike

Is Telehealth Here to Stay?